FEMINISING FACIAL SURGERY

Dr Parag Telang is a board-certified plastic and reconstructive surgeon, practising in the UAE and India. He has done advanced Fellowships in MACS-Lift and Ear reconstruction from Belgium and France. His areas of special interest include facial aesthetic surgery; body contouring surgeries; breast surgeries and rhinoplasty using autologous cartilage. He has done more than 9,000 body contouring surgeries, 400 ear reconstructions, 2,500 breast surgeries and more than 500 rhinoplasties and facelifts.

Know more about feminizing facial surgery from Dr Telang:

Who is a good candidate for a feminising facial surgery?

Facial Feminising surgery (FFS) is for transwomen who want to convert their masculine facial features to more feminine ones.This is an essential step in their gender affirmation surgeries as the society can identify them as appropriate (female) gender only on the basis of their facial appearance. So FFS helps transwomen get an appropriate gender recognition from the society.

Anybody who has been certified as having gender dysphoria by two psychiatrists and has started hormonal treatment since three months or more can opt for this surgery.The age group I would say is between 25-75-years-old. Even cis females can undergo FFS to feminize certain aspects of their face if they feel their face is broad or masculine.

Tell us about the surgical technique adopted by you?

Before the FFS, I have a detailed consultation with the patients to understand their expectation from the surgery. We do a 3D CT scan of the face in order to check the bony width of certain aspects of the face such as brow bone, orbits and jaw. I normally perform FFS in two stages.The first stage, surgeries for upper half of the face: forehead contouring, brow boss reduction, hairline advancement, and feminizing rhinoplasty are performed. In the second stage, surgeries for the lower face: jaw shave, chin contouring and adam’s apple shave are performed.The interval between the two stages is seven to eight days. We use the latest equipment at our centre to minimise the post-operative swelling or bruising and ensure optimum patient comfort.

What is the recovery time and what does the posttreatment care involve?

The recovery for FFS takes two to three weeks.There is swelling around the eyes, jaw and neck areas.There may bruising at some spots.The eyebrows and lower lip can be numb for a few weeks.The patients have to be on liquids or soups for 8-10 days and wear a compression garment called as chin strap for four to six weeks.There are also some scar reducing gels provided to improve the surgical marks.

Any contraindications involved that one should be aware off?

Patients have to be medically fit to undergo FFS. So the blood work has to be within normal limits. Plus they have to be psychologically fit to accept the changes being made to their face as these are more or less permanent alterations being done. Patients are advised to take care of their stitches and take medications regularly as advised.They are counselled properly about what to expect in the immediate post-operative phase so that it becomes easier for them to bear the changes.

Tell us about your most challenging and successful case study?

A challenging case was that of a 65-year-old lady from the UK who had done FFS elsewhere twice and was not happy with her results. She was quite demanding in terms of her expectations. But I am happy to say that she was quite pleased with the final outcome.

The most satisfying case was that of a transwoman who had a twin brother. So after her FFS, we had two versions of her face:A male and a female! The family was ecstatic with the changes that she could have following her surgery.